norfloxacin (Oral route)

Fluoroquinolones, including norfloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants. Fluoroquinolones, including norfloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid in patients with known history of myasthenia gravis .

Commonly used brand name(s)

Uses For norfloxacin

Norfloxacin is used to treat certain bacterial infections in many different parts of the body. Norfloxacin may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

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Norfloxacin belongs to the class of medicines known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, norfloxacin will not work for colds, flu, or other virus infections.

norfloxacin is available only with your doctor's prescription.

Before Using norfloxacin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For norfloxacin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to norfloxacin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of norfloxacin in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of norfloxacin in the elderly. However, elderly patients are more likely to have age-related heart or kidney problems, or develop severe tendon problems (including tendon rupture), which may require caution and an adjustment in the dose for patients receiving norfloxacin.

Pregnancy

Pregnancy Category

Explanation

All Trimesters

C

Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking norfloxacin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using norfloxacin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Amifampridine

Bepridil

Cisapride

Dronedarone

Mesoridazine

Pimozide

Piperaquine

Saquinavir

Sparfloxacin

Terfenadine

Thioridazine

Ziprasidone

Using norfloxacin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose

Acecainide

Acetohexamide

Alfuzosin

Alogliptin

Alosetron

Amiodarone

Amitriptyline

Amoxapine

Anagrelide

Apomorphine

Aripiprazole

Arsenic Trioxide

Asenapine

Astemizole

Azimilide

Azithromycin

Benfluorex

Bretylium

Buserelin

Canagliflozin

Chloroquine

Chlorpromazine

Chlorpropamide

Ciprofloxacin

Citalopram

Clarithromycin

Clomipramine

Clozapine

Crizotinib

Cyclobenzaprine

Dabrafenib

Dapagliflozin

Dasatinib

Degarelix

Delamanid

Desipramine

Deslorelin

Disopyramide

Dofetilide

Dolasetron

Domperidone

Droperidol

Erythromycin

Escitalopram

Exenatide

Fingolimod

Flecainide

Fluconazole

Fluoxetine

Gatifloxacin

Gemifloxacin

Gliclazide

Glimepiride

Glipizide

Gliquidone

Glyburide

Gonadorelin

Goserelin

Granisetron

Halofantrine

Haloperidol

Histrelin

Hydroxychloroquine

Ibutilide

Iloperidone

Imipramine

Insulin

Insulin Aspart, Recombinant

Insulin Bovine

Insulin Degludec

Insulin Detemir

Insulin Glulisine

Insulin Lispro, Recombinant

Ivabradine

Ketoconazole

Lapatinib

Leuprolide

Levofloxacin

Linagliptin

Liraglutide

Lopinavir

Lumefantrine

Mefloquine

Metformin

Methadone

Metronidazole

Mifepristone

Miglitol

Moricizine

Moxifloxacin

Mycophenolate Mofetil

Nafarelin

Nateglinide

Nilotinib

Nortriptyline

Octreotide

Ofloxacin

Ondansetron

Paliperidone

Panobinostat

Pasireotide

Pazopanib

Perflutren Lipid Microsphere

Pioglitazone

Posaconazole

Pramlintide

Procainamide

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quetiapine

Quinidine

Quinine

Ranolazine

Rasagiline

Repaglinide

Rosiglitazone

Salmeterol

Saxagliptin

Sematilide

Sevoflurane

Sitagliptin

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Sunitinib

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Tizanidine

Tolazamide

Tolbutamide

Toremifene

Trazodone

Trifluoperazine

Trimipramine

Triptorelin

Vandetanib

Vardenafil

Vemurafenib

Vildagliptin

Vinflunine

Voriconazole

Warfarin

Using norfloxacin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aluminum Carbonate, Basic

Aluminum Hydroxide

Aluminum Phosphate

Betamethasone

Budesonide

Calcium

Corticotropin

Cortisone

Cosyntropin

Cyclosporine

Deflazacort

Dexamethasone

Didanosine

Dihydroxyaluminum Aminoacetate

Dihydroxyaluminum Sodium Carbonate

Fludrocortisone

Fluocortolone

Hydrocortisone

Iron

Lanthanum Carbonate

Magaldrate

Magnesium Carbonate

Magnesium Hydroxide

Magnesium Oxide

Magnesium Trisilicate

Methylprednisolone

Prednisolone

Prednisone

Probenecid

Sucralfate

Triamcinolone

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using norfloxacin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use norfloxacin, or give you special instructions about the use of food, alcohol, or tobacco.

Dairy Food

Other Medical Problems

The presence of other medical problems may affect the use of norfloxacin. Make sure you tell your doctor if you have any other medical problems, especially:

Bradycardia (slow heartbeat) or

Diabetes or

Diarrhea or

Heart disease or

Heart rhythm problems (eg, prolonged QT interval), or family history of or

Hypokalemia (low potassium in the blood), uncorrected or

Liver disease (including hepatitis) or

Myocardial ischemia (reduced blood supply in the heart) or

Seizures (epilepsy), or history of—Use with caution. May make these conditions worse.

Brain disease (eg, hardening of the arteries) or

Kidney disease or

Organ transplant (eg, heart, kidney, or lung), history of or

Tendon disorder (eg, rheumatoid arthritis), history of—Use with caution. May cause side effects to become worse.

G6PD deficiency (an enzyme problem)—Anemia may occur while using norfloxacin.

Myasthenia gravis (severe muscle weakness), or history of or

Tendinitis (inflammation of the tendon), history of or

Tendon rupture, history of—Should not be used in patients with these conditions.

Proper Use of norfloxacin

Take norfloxacin only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

norfloxacin comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the tablet with a glass (8 ounces) of water. Drink plenty of fluids while you are being treated with norfloxacin. Drinking extra water will help to prevent some unwanted effects of norfloxacin.

Norfloxacin should be taken at least 1 hour before or 2 hours after a meal, milk, or other dairy products.

If you are taking aluminum or magnesium-containing antacids, iron supplements, multivitamins, Didanosine (Videx®), sucralfate (Carafate®), or zinc, do not take them at the same time that you take norfloxacin. It is best to take these medicines at least 2 hours before or 2 hours after taking norfloxacin. These medicines may keep norfloxacin from working properly.

Avoid caffeine-containing products (eg, coffee, soda, or chocolate) while you are using norfloxacin. Norfloxacin may cause caffeine to stay in your body longer than usual.

Keep using norfloxacin for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of norfloxacin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of norfloxacin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):

For infections:

Adults—400 milligrams (mg) every twelve hours for 3 to 21 days, depending on the medical problem being treated. Prostatitis is usually treated for 28 days. Gonorrhea is usually treated with a single oral dose of 800 mg.

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of norfloxacin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using norfloxacin

It is very important that your doctor check your progress while you are using norfloxacin. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

norfloxacin may cause serious allergic reactions including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hives, hoarseness, trouble with breathing, trouble with swallowing, or any swelling of your hands, face, or mouth after you receive norfloxacin.

Serious skin reactions can occur with norfloxacin. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using norfloxacin.

Check with your doctor right away if you have dark urine, clay-colored stools, abdominal or stomach pain, or yellow eyes or skin. These maybe symptoms of a serious liver problem.

Norfloxacin may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to norfloxacin before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. If these reactions are especially bothersome, check with your doctor.

Norfloxacin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using norfloxacin. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Tell your doctor right away if you start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

Norfloxacin may rarely cause inflammation or even tearing of a tendon (the cord that attaches muscles to bones). The risk of having tendon problems may be increased if you are over 60 years of age, using steroid medicines (eg, dexamethasone, prednisolone, prednisone, or Medrol®), if you have severe kidney problems, a history of tendon problems (eg, rheumatoid arthritis), or if you have received an organ (eg, heart, kidney, or lung) transplant. If you get sudden pain or swelling in a tendon after exercise (eg, in the ankle, back of the knee or leg, shoulder, elbow, or wrist), stop using norfloxacin and check with your doctor right away. Refrain from exercise until your doctor says otherwise.

Some people who take norfloxacin may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you begin using norfloxacin:

Stay out of direct sunlight, especially between the hours of 10:00 AM and 3:00 PM, if possible.

Wear protective clothing, including a hat and sunglasses.

Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.

Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

norfloxacin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

pains in the stomach, side, or abdomen, possibly radiating to the back

personality changes

pinpoint red spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

red, swollen skin

scaly skin

seizures

severe sunburn

severe tiredness

shakiness and unsteady walk

skin rash

slurred speech

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sores, welting, or blisters

stomach pain, continuing

sudden decrease in the amount of urine

sudden numbness and weakness in the arms and legs

swelling of the face, fingers, or lower legs

swelling or inflammation of the mouth

swollen glands

tightness in the chest

unexplained weight loss

unpleasant breath odor

unsteadiness, awkwardness, trembling, or other problems with muscle control or coordination

unusual behavior, such as disorientation to time or place, failure to recognize people, hyperactivity, or restlessness

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight loss

vomiting of blood

weakness in the arms, hands, legs, or feet

weight gain

wheezing

yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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